简介：AbstractThe pathogenesis of melasma is believed to be related to heredity, sun exposure, sex hormones, and other factors. The mechanisms underlying the development of melasma include increased melanin synthesis, vascular proliferation within the skin lesions, inflammation, and skin barrier dysfunction. The diagnosis of melasma is mainly based on clinical manifestations and noninvasive techniques. Coupling with recent research progress in melasma, the present consensus comprehensively elaborates the etiology, pathogenesis, clinical manifestations, staging, classification, diagnosis, and treatment of melasma to improve the diagnostic and therapeutic skills of Chinese dermatologists.

简介：AbstractMeningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients.

简介：某些疾病被知道引起变化在物理并且房间的biomechanical性质。这些在其它之中包括癌症，疟疾，和镰刀房间贫血症。典型地，如此的物理性质变化能导致房间僵硬的几褶层增加或减少，它是重要的并且能导致严重病理和最终的灾难的故障身体功能。当有时开发了生物化学、生物的试金检测疾病的发作或存在，总是有需要开发更快速、精确、敏感的方法检测并且诊断疾病。Biomechanical性质变化能起一个重要作用在这方面。因此，对疾病biomechanics的研究不能仅仅给我们位于疾病前进下面的机制的深入的知识，但是能也为察觉和诊断用作一个强大的工具。这篇文章提供一些卓见进机会因为在疾病的发作或前进期间在细胞的机械性质换掉怎么重要，能为察觉和诊断作为有用工具被利用。我们将也展示已经被开发了执行如此的察觉和诊断的几种技术。

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简介：ThispaperputsforwardanewfaultdiagnosismodelbasedonPetrinet.Inthisnewfaultdiagnosismethod,anassociatedtreeisfirstdefinedtodescribethelogicaccordingtotheprotectionsandcircuitbreakers.AfterthataPetrinetdiagnosismodelcomesintobeingandtheprecisediagnosisofpowergridelementscanberealizedatthesametime.Thesimulationresultsgiveninthispaperillustratethatthisfaultdiagnosismethodcanmakearapiddiagnosisincomplexfaultsituationandgiveaccurateresultstopowergridfaultdiagnosis.

简介：AbstractGonorrhea is one of the main sexually transmitted diseases in China. It mainly affects the genitourinary tract, and its clinical manifestations vary from asymptomatic to complicated types. The diagnosis of gonorrhea should be based on the patient’s epidemiological history, clinical manifestations, and laboratory examination results. Treatment should be prompt and standardized and should involve the recommended treatment regimens. Patients should be appropriately followed up after treatment. The antimicrobial resistance of gonococcal isolates has become a severe problem of clinical concern. In order to provide technical guidance of the diagnosis and treatment of gonorrhea for health care workers, the authors developed the guidelines based on the version of 2014, which will be of important in the standardizing medical care of gonorrhea, and further facilitating control and prevention of the disease.

简介：ＥＮＥＲＧＥＴＩＣＤＩＡＧＮＯＳＩＳＦＯＲＴＷＯＫＩＮＤＳＯＦＬＯＷＬＥＶＥＬＪＥＴＳＷａｎｇＺｈｏｎｇｘｉｎｇ（汪钟兴）（矫梅燕）（１．ＤｅｐａｒｔｍｅｎｔｏｆＥａｒｔｈａｎｄＳｐａｃｅＳｃｉｅｎｃｅｓ，ＵｎｉｖｅｒｓｉｔｙｏｆＳｃｉｅｎｃｅａｎｄ...

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简介：AbstractVitiligo is a common depigmented skin disease that negatively affects the physical and mental health of patients. The 2018 version of the Vitiligo Treatment Consensus has been updated based on the research progress on vitiligo in the past 3 years in combination with the clinical experiences of experts. The newly revised points include maintenance therapy, early glucocorticoid intervention, and oral mini-pulsed glucocorticoid administration protocols. The prospect of using JAK inhibitors in the treatment of vitiligo is also discussed.

简介：Objective:Toevaluatetheclinicalutilityoftestingserumanti-treponemapallidumIgMantibodyinthediagnosisofsyphilispatients.Methods:Seventy-twocasesofsyphilisweretestedforspecificIgMantibodywithELISA,andtheresultswerecomparedwithRPRandTPPA.Results:ThesensitivityofIgMantibodywas73.3%(11/15)inprimarysyphilis,88.9%(16/18)insec-ondarysyphilis,andtherewasnosignificantdiffer-encebetweenthesevalues(x^2=1.6363,P>0.10).ThesensitivityofIgMantibodyindiagnosinglatentsyphi-liswasonly26.1%(6/23),muchlowerthanthedetec-tionrateinsymptomaticearlvsvDhilis(x^2=17.6189.P<0.005).RPRandTPPAwereboth100%sensitiveinlatentandearlysymptomaticsyphilis.Twowereposi,fiveforIgMinthe16caseswhohadreceivedregulartreatments2to24monthsbeforeenrolled.Conclusions:SpecificIgMantibodydetectiondoeesnotappearsuperiortoRPRandTPPAindiagnosingprimarysyphilis.ThediagnosisoflatentsyphilisshouldmainlyrelyonRPRandTPPA,sincetherearelowtitersofIgMantibodyatthatstage.IgMantibodytestingaloneshouldnotberecommendedformonitor-ingsyphilisdevelopmentortreatmentefficacy.Fur-therstudiesshouldbeconcerned.

简介：AbstractImportance:There is a high incidence of iron deficiency in children worldwide. Notably, however, while iron deficiency is the most common cause of anemia, little is known about the prevalence and different types of iron deficiency in neuroblastoma patients.Objective:The aim of the present study was to investigate the prevalence of iron deficiency in patients newly diagnosed with neuroblastoma.Methods:A total of 195 newly diagnosed neuroblastoma patients from November 2015 to January 2018 were analyzed retrospectively. The survival analysis was estimated by the Kaplan-Meier method.Results:Of the 195 neuroblastoma patients included in the study, 121 (62.1%) had iron deficiency, 55 (28.2%) had absolute iron deficiency, and 66 (33.9%) had functional iron deficiency. Being aged ≥ 18 months, tumor originating in the abdomen, International Neuroblastoma Risk Group Staging System M, high-risk neuroblastoma, lactate dehydrogenase ≥ 1500 U/L, neuron-specific enolase ≥ 100 U/L, unfavorable histologic category, MYCN amplification, chromosome 1p loss, and bone marrow metastasis were associated with significantly higher rates of functional iron deficiency (P < 0.05).Interpretation:Functional iron deficiency at the time of initial neuroblastoma diagnosis predicted lower event-free survival. Long-term effects of iron supplementation in neuroblastoma patients with different types of iron deficiency need to be further studied.

简介：Objective:ToevaluatethevalueofenhancedluminescenceenzymeimmunoassayinthediagnosisofNeisseriagonorrhea(NG)infection.Methods:Anti-catalaseantibodyforNeisseriagonorrheaecombinedwithenhancedluminescenceenzymeimmunoassaywereusedtotestforN.gonorrhea.Results:Aminimumof1×10^4/CFUofGCingenitaltractsecretionsorurinecouldbedetectedwiththetechniqueofluminescenceenzymeimmunoassay.Conclusion:TheenhancedluminescenceenzymeimmunoassayhastheadvantageofhighsensitivityandspecificityfordiagnosingNGfromgenitourinarytractsecretionandurine.

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简介：Theboilerisoneofthekeypartsofpowerstation.Monitoringtheoperationoftheboilerautomatically,continuouslyandaccuratelyisveryimportant.Incaseofmalfunctions,anexpertsystemmightbehelpfultofindthesourcesoffaults,andthereafterwillassisttheoperatortoactcorrectlyandtopreventthefaultfromfurtherdevelopment.Inthispaper,asimulationstudyofanexpertsystem,whichcandiagnosetherunningfaultsofboilersystem,isconducted.Shallowanddeeptwo-layerknowledgebasestructureisusedinthistwolayersofknowledgebase.So.thiskindofexpertsystemcanovercomethedisadvantagesoftheoldtypesofexpertsystems,whichareonlyabletodealwithexperiencerulesbase.Asimulatorofpowerboilerisusedfortheresearchonfaultdiagnoseexpertsystem.Thisboilersimulatorgivesallnecessaryinformationforthediagnosis.Theknowledgebaseofexpertsystemisbuiltinhierarchies,sothespeedofreasoningmaybeinvreased.Afterthereasoningthesys

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简介：AbstractIntroduction:Basal cell carcinoma (BCC) is the most common human malignancy commonly in white people, but in less than 1% of cases it may appear on unexposed areas, like the perineal and anal regions. Vulvar BCC is often diagnosed late because it grows slowly and tends to be asymptomatic, with no specific physical findings. Here, we present a rare Latin patient with a 10-year history of vulvar BCC with dermatoscopic and histopathologic findings.Case report:A 65-year-old Latin woman presented with a nodule on her left labium majus, which she first noted 10 years ago, and that had grown slowly but constantly. She also reported a 20-year history of pruritus and occasional pain. Physical examination showed a 3.5 cm × 3.0 cm erythematous lesion with a central rough without inguinal lymphadenopathy. Contact dermatoscopy (Dermalite DL3 Gen.) showed one blurred cluster of arborising vessels in a pinkish background with white homogeneous areas and lines radial converging. An incisional biopsy was realized, and histopathology diagnosed BCC.Discussion:Vulvar BCC is a rare malignancy that affects mainly Caucasian women over 70 years of age. The most common etiology for BCC is ultraviolet radiation, but as the vulva is unexposed its cause is unclear. Mutations in tumor suppressor and regulatory genes such as p53 are present in 50% of cases. Gorlin syndrome, chronic radiation, chronic arsenic exposure, xeroderma pigmentosum, and immunosuppression have been considered as risk factors.Conclusion:Vulvar BCC characteristics are the same as other cutaneous forms, featuring blue ovoid nests and arborizing telangiectasia, confused with inflammatory diseases, such as eczema, psoriasis, and chronic infection (especially if it is accompanied by pruritus), this makes diagnosis complex, with a delay of 5 to 6 years on average, with an average size of 2.1 cm. Diagnosis is enhanced with dermatoscopy, as the preferred treatment for most BCC cases is wide surgical excision.

简介：AbstractObjective:This study was to supply information of the Duchenne muscular dystrophy (DMD) mutational spectrum in 303 Chinese families and further offer 5-year clinical experience of DMD/Becker muscular dystrophy genetic counseling and prenatal diagnosis.Methods:In this retrospective cohort study, three hundred and five pregnancies in 303 pregnant women who has a birth history of DMD/Becker muscular dystrophy patients underwent prenatal diagnosis using multiplex ligation-dependent probe amplification followed by Sanger sequencing between January 2014 and December 2018 at Peking Union Medical College Hospital. The mean age of pregnant women was (33.0 ± 4.1) years old. Karyotype analysis was performed to exclude fetal abnormal karyotype.Results:The detection rate of DMD gene mutation in 303 probands was (296/303) 97.7% with seven families having a negative genetic diagnosis. The mutational spectrum comprised of large arrangements in 288/303 (95.0%) and small mutations in 8/303 (2.6%). Carrier testing was performed among 204 pregnant women among whom, 108 mothers had the same mutation as family proband. Of the 305 pregnancies underwent prenatal diagnosis, 55 of 173 male fetuses were affected. We also performed karyotype analysis and found three abnormal karyotypes of trisomy 21. We even found a fetus with DMD gene mutation and trisomy 21 in a same fetus by further analysis. We also identified two times of germline mosaicism.Conclusion:This study demonstrated the distribution and mutation profile of 303 probands and 305 fetuses. Furthermore, considering the possbility of maternl germilne mosaicism, prenatal diagnosis should be suggested to mothers with a proband whether they carry the causative mutation in their blood or not.

简介：AbstractHyperglycemia is one of the most common complications women encounter during pregnancy, and is associated with a higher incidence of short- and long-term health risks for both the mother and offspring. In 2022, the Maternal-Fetal Medicine Committee of the Chinese Society of Obstetrics and Gynecology, Chinese Medicine Association, worked with the Chinese Society of Perinatal Medicine and the Professional Committee of Gestational Diabetes Mellitus of the Chinese Maternal and Child Health Association to update the Guidelines for the diagnosis and management of hyperglycemia in pregnancy in China. The aim was to further standardize the management of hyperglycemia in pregnancy from the aspects of screening, diagnosis, monitoring, treatment, and prevention of gestational diabetes mellitus, and consequently to further improve the health of mother and child.

简介：AbstractTwin reversed arterial perfusion sequence, a severe and unique complication of monochorionic multiple pregnancy, is characterized by vascular anastomosis and abnormal or absent cardiac development in the twins. This article reviewed its pathogenesis, prenatal ultrasound diagnosis, and management. The pump twin’s chances for survival can be maximized by proper management. The optimal timing of the interventions remains a debate, although the latest studies encourage early intervention, i.e., in the first trimester. The most preferred approach is to interrupt the vascular supply to the acardius, such as through ultrasound-guided laser coagulation and radiofrequency ablation of the intrafetal vessels.